Strategies for Incorporating Culture into Psychosocial Interventions for Youth of Color

ABSTRACT

This review summarized the literature on psychosocial interventions for youth of color. Ninety-three journal articles of randomized clinical trials, with samples comprising youth of color, published between 1974 and 2018 were coded for sample characteristics, intervention characteristics, and strategies for incorporating culture into psychotherapy. Results found 69 psychosocial interventions to be efficacious for youth of color; 32% of these psychosocial interventions included a strategy for incorporating culture into psychotherapy. The evidence base was largest for Black and Hispanic/Latinx populations and for psychosocial interventions targeting disruptive behavior problems. The most common strategies for incorporating culture into treatment among effective psychosocial interventions were employing procedures for addressing cultural context and including providers with awareness and knowledge of the client’s culture. The inclusion of strategies for incorporating culture was not associated with treatment efficacy. Findings from this review highlight the laudable efforts that have been made to identify efficacious psychosocial interventions for youth of color and illuminate remaining gaps in the evidence base (e.g., efficacious psychosocial interventions for Asian, Native American and Alaska Native, and Native Hawaiian and Pacific Islander youth). Findings also emphasize the nuance of providing effective mental health services that are compatible with client’s cultural worldviews, values, and practices and allude to the promise of decision support tools to help providers determine whether, when, and how to culturally tailor their psychotherapy with youth of color.

Disclosure statement

Dr Chorpita is the President of PracticeWise, LLC, which manages the PracticeWise Evidence-Based Services (PWEBS) Literature Database and created the PracticeWise Clinical Coding System referenced in this study.

Data availability statement

The data that support the findings of this study are available from the corresponding author, AP, upon reasonable request.

Notes

¹ Whaley and Davis (2007) define culture as “a dynamic process involving worldviews and ways of living in a physical and social environment shared by groups, which are passed from generation to generation and may be modified by contacts between cultures in a particular social, historical, and political context” (p. 564). Although this systematic review focuses on racial and ethnic groups, we use the term culture when referring to worldviews, values, and practices shared by groups that are not solely identified by race and ethnicity (e.g., language, nationality).

² The terms culturally tailored, culturally adapted, culturally competent, culturally responsive, and culturally sensitive have somewhat different meanings but tend to be used interchangeably by scholars (S. J. Huey et al., 2014). In this paper, we use the first term because cultural tailoring refers a more purposeful process of incorporating cultural factors into interventions.

³ Studies were coded for the percentage of participants who identified as White, Black or African American, Hispanic or Latinx, Native American or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, multiracial, or “other” race. Notably, race and ethnicity are not uniformly reported in the mental health services literature. Accordingly, race and ethnicity were coded to the best of the coder’s ability based on the information available in the study. For example, participants who identified as Hispanic may have been coded as Hispanic or Latinx, White, or other depending on how the authors of the journal article categorized race and ethnicity (e.g., Pimentel & Balzhiser, 2012).

⁴ The same pattern of results was found when using a logistic regression with any cultural tailoring, tailored conceptualization, tailored message, tailored procedures, tailored therapeutic style, tailored communication, and tailored change agent predicting winning status.

Additional information

Funding

The authors received no specific funding for this work.